Latest From California Healthline:

With the primary now over, health care may well emerge as an issue that helps voters distinguish between candidates for governor, attorney general and other offices in the general election. (Chad Terhune and Pauline Bartolone and Ana B. Ibarra and Alex Leeds Matthews,
6/7)

The community of Surprise Valley, Calif., wrestled with the idea of selling its tiny, long-cherished hospital to a Denver entrepreneur who sees a big future in lab tests for faraway patients. Last summer, another exec had a similar idea but left town. (Barbara Feder Ostrov,
6/6)

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Summaries Of The News:

The race for California governor was narrowed down to Democrat Gavin Newsom and Republican John Cox. The outcome of the race could both shape the fate of the Affordable Care Act in the state and influence whether Republicans in Washington take another shot at dismantling the landmark law. “For the Affordable Care Act, California is a bellwether state,” said David Blumenthal, president of the Commonwealth Fund.

The New York Times:
In Fight For California Governor, Candidates Head To Ideological Corners
In most elections, the primary is the season for partisanship and appealing to the party’s most ideological voters. Candidates slide to the center — appealing, in theory, to a broader electorate with a more moderate message — as they shift into a general election. But even before most of the votes were counted, two of the candidates running to be the next governor of California — Gavin Newsom, the Democratic lieutenant governor, and John Cox, a Republican businessman — made clear that they were inclined to stay in their ideological corners. (Nagourney and Fuller, 6/6)

California Healthline:
Californians Face ‘Real Choice’ On Health Care In November
In the California governor’s race, Democratic front-runner Gavin Newsom quickly sought to cast the November contest as a referendum on Trump and his effort to undo much of President Barack Obama’s legacy, particularly on health care. A series of Trump tweets endorsing Republican candidate John Cox, a multimillionaire real estate investor, helped propel the political outsider to the general election. “It looks like voters will have a real choice — between a governor who will stand up to Donald Trump and a foot soldier in his war on California,” Newsom said Tuesday night to supporters in San Francisco. (Terhune, Bartolone, Ibarra and Matthews, 6/7)

The New York Times:
5 Takeaways From California’s Primary, For Californians
Health care had been front-and-center in the governor’s race — at least between the top two Democrats, Mr. Newsom and Mr. Villaraigosa. Mr. Newsom has supported single-payer health care for all residents, while Mr. Villaraigosa has raised questions about how to pay for it. The divide has mirrored the split within the Democratic Party, with the most progressive leaders — which in addition to Mr. Newsom includes Mr. De Leon — making the issue an important part of their platform, and moderates raising questions about where the money will come from. Given the high cost of universal health care, and no reasonable way to pay for it without increasing taxes, “it’s more of an aspiration,” Mr. Baldassare said. “The belief is, yes, it’s a good idea. And then the question is, how do we pay for it?” (Arango and Medina, 6/6)

The ban is one of the strictest in the nation, and R.J. Reynolds poured millions into getting it overturned. The campaign to keep the ban spent about $2.3 million, with the lion’s share coming from former New York City mayor and billionaire philanthropist Michael Bloomberg.

The New York Times:
San Francisco Voters Uphold Ban On Flavored Vaping Products
Despite a $12 million ad blizzard by a giant tobacco company, voters in San Francisco resoundingly supported a new ban on the selling of flavored tobacco products, including vaping liquids packaged as candies and juice boxes, and menthol cigarettes. The measure, known as Proposition E, is said to be the most restrictive in the country, and health groups predicted it could serve as a model for other communities. (Hoffman, 6/6)

The Hill:
San Francisco Voters Approve Ban On Flavored Tobacco
The San Francisco city supervisors approved the ordinance last year, but opponents got enough signatures to place the question on the ballot.
The vote Tuesday puts to rest what has become a long and expensive battle, with tobacco company R.J. Reynolds contributing nearly $12 million against the measure. On the other side, supporters of the measure were funded almost entirely by former New York City Mayor Michael Bloomberg, who contributed at least $1.8 million. Matthew Myers, president of the Campaign for Tobacco-Free Kids, called the vote "a truly historic victory for kids and health over the tobacco industry." (Hellmann and Wilson, 6/6)

Politico:
San Francisco Voters Uphold Sweeping Ban On Flavored Tobacco
Tobacco and public health interests spent millions of dollars ahead of the closely watched referendum, which came as the FDA explores new limits on flavored tobacco and grapples with the challenge of regulating products like e-cigarettes that some argue are a safer alternative and can wean smokers off traditional smoking products. (Colliver, 6/6)

KQED:
San Francisco Passes First-In-The-Nation Flavored Tobacco, Vaping Ban
San Francisco could became the first city in the nation to ban flavored tobacco products from all store shelves. This includes everything from candy flavored e-cigarettes to conventional menthol smokes. City supervisors last year unanimously approved a ban on the products, but the tobacco industry funded a referendum, Proposition E, to put the issue before voters. Residents will decide in the June 5 election whether the ordinance goes into effect. Voting by mail has already begun. (McClurg, 6/6)

The partnership at the center of Anthem’s legal challenge was forged last spring as a way to help the financially strapped Sebastopol hospital.

Santa Rosa Press Democrat:
Anthem Blue Cross Lawsuit Accuses Sebastopol Hospital Of Fraudulent Billing
Health insurance giant Anthem Blue Cross has filed suit against Sonoma West Medical Center, accusing the Sebastopol hospital of conspiring with an out-of-state medical laboratory in a billing scheme that Anthem claims defrauded it and its members of $16 million. The lawsuit, filed June 1 in U.S. District Court, alleges that Sonoma West Medical Center knowingly allowed Florida-based Reliance Labs to use it as a drug testing front. Reliance allegedly used the hospital provider’s credentials to bill for testing on urine samples taken from Anthem members who were not local patients and had never visited the Sebastopol facility, according to the lawsuit. (Espinoza, 6/6)

The Medical Board hearing this week in Los Angeles will determine whether Dr. Carmen Puliafito, the former medical school dean who has been accused of inappropriate behavior including drug use, is allowed to resume practicing medicine.

Los Angeles Times:
Top USC Medical School Official Feared Dean Was 'Doing Drugs' And Alerted Administration, He Testifies
A former vice dean of USC’s Keck School of Medicine testified Tuesday that he feared the school’s then-dean, Dr. Carmen A. Puliafito, “could be doing drugs” and expressed concerns about his general well-being to the university’s No. 2 administrator before Puliafito abruptly left his job in 2016. Dr. Henri Ford’s testimony at a hearing of the state Medical Board marks the first suggestion that any USC administrator had suspicions about Puliafito’s possible drug use before he stepped down. (Elmahrek and Pringle, 6/5)

Treatment centers are seeing an upswing in people seeking help for marijuana dependency. But as the drug gains in popularity and public acceptance, doctors are battling the misconception that pot is not addicting. In other public health news: liver disease and homelessness.

Stateline:
Yes, You Can Become Addicted To Marijuana. And The Problem Is Growing.
Many people are unaware of marijuana addiction. But in the public health and medical communities, it is a well-defined disorder that includes physical withdrawal symptoms, cravings and psychological dependence. Many say it is on the rise, perhaps because of the increasing potency of genetically engineered plants and the use of concentrated products, or because more marijuana users are partaking multiple times a day. ...Although estimates of the number of people who have ever tried marijuana or who use it regularly vary widely from survey to survey, the federal government and the marijuana industry tend to agree that total marijuana use has remained relatively constant over the past decade. Increased use in the past three years has been slight, despite increased commercial availability in states that have legalized it. (Vestal, 6/6)

Sacramento Bee:
A Liver Disease You've Never Heard Of Is Putting 12 Million Americans' Lives At Risk
Liver specialists say there’s a form of hepatitis that is sneaking up on about 12 percent of the U.S. population, an estimated 25 million Americans, and they want to urge primary-care providers to send patients for testing earlier in the game. Called nonalcoholic steatohepatitis, or NASH for short, it does not result from drug use, alcoholism, sexual contact, water contaminants or viruses. Rather this particular liver condition occurs when too much fat is stored in liver cells. (Anderson, 6/7)

The California Health Report:
Who Becomes Homeless? Data Paints A Startling Picture
According to last year’s point-in-time count, only 15 percent of Orange County’s homeless population had been released from jail or prison in the past 12 months. Nine percent of homeless adults have chronic substance abuse—down from 30 percent since 2013—and 12 percent have a serious mental illness—also down in the past five years. County Probation Department officials also told the nonprofit news site Voice of OC in March that only one convicted sex offender was among the 700 homeless people in the Riverbed—and that he would not have been eligible to stay at the proposed shelters. (Kandil, 6/6)

“It takes a little bit of social work to deal with kids,” said Officer Deandre Dudley, who works as a rotating school resource officer at the 27 schools in the area. “It’s not cookie cutter. You have to exercise restorative justice. You have to exercise a little more patience, diplomacy.”

San Francisco Chronicle:
San Francisco Cops Go Back To School To Better Understand Teens
The officers had been instructed to aggressively question the teens, who were told to then tell the officers how it made them feel. The seminar was part of a four-day training called Policing the Teen Brain, which is designed to help about 25 city police officers improve relationships with children and teens and equip cops with tools to de-escalate situations and avoid the use of force. (Ravani, 6/6)

Los Angeles Times:
Costa Mesa Council Approves Permit For Eastside Sober-Living Home
The third time ended up being the charm for a sober-living operator Tuesday as the Costa Mesa City Council officially awarded a required permit for its facility on the Eastside. However, in granting the sought-after approval, the council lowered the maximum occupancy for the Summit Coastal Living home — located in three units at 2041 Tustin Ave. — from the requested 12 residents to eight, plus a live-in manager. (Money, 6/6)

Ventura County Star:
Chergey Insurance Announces Staff Promotions
Chergey Insurance, a full-service insurance brokerage in Thousand Oaks, has promoted Shannon Roehr, Steve Sanders and Rick Brown to the position of vice president of sales.“We are extremely proud of their hard work and have rewarded them as they continue to build on their careers at Chergey Insurance,” said company President Dan Chergey. Roehr has been an insurance broker for more than four years after many years in marketing. Her specialties include workers’ compensation and group health insurance. (6/7)

HHS Secretary Alex Azar, while testifying to Congress Wednesday, defended the Trump administration from claims it was trying to sabotage the health law. Azar also said that President Donald Trump is taking steps to try to make coverage more affordable, such as extending short-term policies and allowing association health plans. The secretary spoke about Medicare, as well.

The New York Times:
Alex Azar, Health Secretary, Denies Sabotaging Insurance Markets
Alex M. Azar II, the secretary of health and human services, denied on Wednesday that Trump administration policies were driving up health insurance costs, which many experts expect to surge again in 2019. Mr. Azar, testifying before a House committee, vigorously disputed suggestions by Democrats that President Trump had sabotaged Affordable Care Act marketplaces, where millions of people obtain insurance subsidized by the federal government. (Pear, 6/6)

Kaiser Health News:
HHS To Allow Insurers’ Workaround On 2019 Prices
Federal officials will not block insurance companies from again using a workaround to cushion a steep rise in health premiums caused by President Donald Trump’s cancellation of a program established under the Affordable Care Act, Health and Human Services Secretary Alex Azar announced Wednesday. The technique — called “silver loading” because it pushed price increases onto the silver-level plans in the ACA marketplaces — was used by many states for 2018 policies. But federal officials had hinted they might bar the practice next year. (Rovner, 6/7)

Modern Healthcare:
Azar And Congress Seek To Fix Medicare Wage Index
HHS Secretary Alex Azar told lawmakers they should draft legislation to update and fix the Medicare wage index. The index, which was created in the 1980s, sets payments to hospitals as adjusted for market conditions, such as the differences in hospital wage rates among labor markets. It also takes into account the cost of living. Increasingly, rural hospitals in areas where the cost of living tends to be lower cite the index as a reason for closures. (Dickson, 6/6)

The VA Mission Act, which Congress passed with bipartisan support before Memorial Day, was designed to overhaul the way veterans get private-sector care, close or consolidate underused facilities and provide new incentives to hire doctors, among other changes. Lawmakers are still trying to pay for the legislation, but President Donald Trump is opposed to their plan to fund the changes.

The Associated Press:
Trump Signs Bill To Expand Private Care At Troubled VA
President Donald Trump signed a bill into law Wednesday that will give veterans more freedom to see doctors outside the troubled Veterans Affairs system, a major shift aimed at reducing wait times and improving care by steering more patients to the private sector. At a Rose Garden event at the White House, Trump praised the legislation as fulfilling his pledge to fix the Department of Veterans Affairs by bringing accountability and providing private care to veterans whenever they feel unhappy with government-run health care. (6/6)

The Washington Post:
Trump Signs Veterans Health Bill As White House Works Against Bipartisan Plan To Fund It
“The VA Mission Act authorizes and expansion of veterans’ access to private health care, but the bill does not reserve federal money to pay for it. A group of powerful Senate committee chairmen from both parties aims to remedy that by advancing a separate measure for the new $50 billion law, saying this is the best way to ensure the new programs give veterans access to medical care. But the White House has been lobbying Republicans to vote the plan down, instead asking Congress to pay for veterans programs by cutting spending elsewhere. (Werner and Rein, 6/6)

The Wall Street Journal:
Trump Launches Revamp Of Veterans’ Health Care. Can A Rudderless VA Carry It Out?
One of the central purposes of the law is to replace emergency legislation called the Choice Act, which was passed after a VA wait-time scandal sparked demand to change the department and give veterans more choice for their health care. Congress pushed through the Choice Act in 2014, mandating that the VA implement it within 90 days, which set the program up for failure, said Rep. Phil Roe (R., Tenn.), the chairman of the House Committee on Veterans’ Affairs. Earlier this week, a Government Accountability Office report said the VA “cannot determine whether the Choice Program has helped to achieve the goal of alleviating veterans’ wait times for care.” “We started this four years ago,” Mr. Roe said. “It’s one of the most sweeping pieces of legislation we’ve passed since I’ve been” in Congress, he said. (Kesling, 6/6)

The legislation gives companies more wiggle room, but most of them don't want it and are not going to use it. Patients are "no better off today with Right to Try than [they were] yesterday," says Arthur Caplan, head of medical ethics at NYU School of Medicine. In national health care news: lawmakers want companies to develop new antibiotics but they're not offering any extra incentives for them to do so; Sen. Claire McCaskill (D-Mo.) wants to increase transparency over payments to patient advocacy groups; tips on getting around pharmacists' gag rule; and more.

The Wall Street Journal:
The ‘Right To Try’ Law Says Yes, The Drug Company Says No
Radha Rangarajan loves Moana and Elmo, the playground and the “Pout-Pout Fish” book. Like most 2-year-olds, she speaks in two-to-three-word sentences. (“Go outside!” “Mama sit.”) She gives kisses to anyone who asks. But Radha’s life is far from normal. She can’t walk without assistance. Her health will probably deteriorate rapidly in coming months. (Reddy, 6/6)

Stat:
Lawmakers Push For New Antibiotics, But Stop Short Of Offering Incentives
House lawmakers on both sides of the aisle Wednesday stressed the importance of developing new antibiotics, though the draft bill they discussed did not include any of the specific incentives advocates say are necessary to promote such drug development. Left to their own devices and the stimuli of the market, companies simply won’t develop the antibiotics the world needs. Infections resistant to the current supply of medicines kill tens of thousands of Americans each year, and many more worldwide. But these drugs can’t turn a huge profit, and the more they are used, the less effective they can become, making it difficult for companies to recoup their investment. (Swetlitz, 6/6)

Stat:
McCaskill Bill Would Make Pharma Report Payments To Patient Advocacy Groups
Looking to bolster transparency involving drug makers, Sen. Claire McCaskill (D-Mo.) introduced a bill that would require drug makers to report payments that are made to patient advocacy groups and professional societies. The legislation is designed to toughen the Sunshine Act, which was created in response to concerns that industry payments were unduly influencing medical research and practice. The law was subsequently folded into the Affordable Care Act and a federal database was launched in 2014 to which drug and device makers must report payments to physicians. (Silverman, 6/6)

Politico:
Trump Seeks To Reorganize The Federal Government
The Trump administration is preparing to release a sweeping plan for reorganizing the federal government that includes a major consolidation of welfare programs — and a renaming of the Health and Human Services Department. The report, set to be released in the coming weeks by the White House Office of Management and Budget, seeks to move safety-net programs, including food stamps, into HHS, two sources with knowledge of the plan told POLITICO. The plan would also propose changing the name of the sprawling department, while separately seeking cuts at the U.S. Agency for International Development and the State Department. (Bottemiller Evich and Restuccia, 6/6)

The Associated Press:
More Americans Screened Over Mystery Health Issues In China
A U.S. medical team was screening more Americans who work in a southern Chinese city as the State Department confirmed evacuating a number of government workers who experienced unexplained health issues like those that have hurt U.S. personnel in Cuba and China. The evacuations of the workers in Guangzhou followed medical testing that revealed they might have been affected. State Department spokeswoman Heather Nauert said "a number of individuals" have been brought to the U.S. but didn't say how many were affected or evacuated. One case in Guangzhou had been disclosed last month. (6/7)

The New York Times:
What Do These Political Ads Have In Common? The Opioid Crisis.
The scenes in the political ads play out in almost the same order: A heartbreaking story about someone who can’t seem to stop taking drugs. A grim statistic about opioids. And then a somber pitch from a candidate promising solutions. More and more, politicians in competitive races are using emotional pleas about opioid abuse to woo voters. In states like Wisconsin, where hundreds of people are dying of opioid overdoses every year, candidates are talking about drugs in stump speeches, on Facebook and in ads. (Smith, 6/7)